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Failure Rates Decrease with Hip Resurfacing for Young Arthritic Patients

Younger adults with hip arthritis have more treatment options now thanks to a procedure called hip resurfacing. Instead of removing the damaged head of the femur (thighbone), the surface can be smoothed and rounded again. A metal cap is placed over the new surface. Sometimes the hip socket is also replaced with a thin metal cup.

New designs of hip resurfacing have decreased the failure rates by up to 30 per cent. This news was presented at the 2007 Annual Meeting of the American Orthopaedic Association.

Since the first resurfacing implants were used, the type and design have improved. The surgical tools used to do the operation are better. And surgeons are choosing patients more carefully. These changes have made it possible for long-term success of hip resurfacing.

Patient selection for this procedure is limited to those patients who are younger than 65 years old. They must not have osteopenia, a decrease in bone mineral density. A low risk index is desirable.

The risk index used is called the surface arthroplasty risk index (SARI). It is a tool that scores patients based on the number of risk factors for implant failure. A total score should be less than three before the person is considered a candidate for hip joint resurfacing.

Hip resurfacing has its own pros and cons. These are different from total joint replacement. The risk of femoral neck fracture is much higher with resurfacing. Metal ion release can cause problems later with loosening of the implant.

But the faster recovery and improved function make this a desirable option for hip arthritis in younger adults. Returning to full function and getting back to work sooner are major benefits of this operation.

References: Susan M. Rapp. Low Morbidity, Few Dislocations Make Hip Resurfacing An Option for Young Patients. In Orthopedics Today. Vol. 27. No. 8. Pp. 1, 10.

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